Clinical Pharmacy Services Provided in Public Sector Hospitals in Nigeria: A National Survey

Background: Studies show that clinical pharmacy services are effective in optimizing medicines use and patients outcomes. This study aimed to determine the clinical pharmacy services provided in public sector hospitals in Nigeria. Methods: This was an online survey of 296 primary, secondary and tertiary care hospitals sampled purposively across the 36 States and Federal Capital Territory in Nigeria. Data analysis was conducted descriptively, and via Chi-square test and multivariate analysis of variance (MANOVA). Key findings: Complete responses were obtained from 272 hospitals in the country with a survey completion rate of 88%. This included 55 tertiary, 72 secondary, and 145 primary healthcare centres (PHCs). Pharmacists provided pharmaceutical care services in all the tertiary care hospitals, 94% of the secondary, and in only 6% of the PHCs surveyed. The composition of the pharmacy department per level of care was similar across the six geopolitical regions (V = 0.383, F = 1.453, p = 0.06) with more pharmacy staff employed in the tertiary care hospitals compared to the secondary care facilities. The majority (>=75%) of the tertiary and secondary care hospitals in the survey provided medicines information, patient education and counselling, alongside in- and outpatient dispensing services. However, fewer than 30% reported routine pharmacist involvement in multidisciplinary ward rounds, medication chart review, therapeutic guidelines development, antibiotic stewardship programmes, and drug therapy monitoring. Pharmacists routinely provided medication error reporting services in only about half of the hospitals in the sample, and this was not associated with the level of care (p>0.05). Conclusions: The findings of this study demonstrate disparity in clinical pharmacy service availability across the various levels of care in Nigeria. It also highlights the need to scale up and prioritize their integration within the primary care sector.